title: Cardiovascular fitness, insulin resistance and metabolic syndrome in severely obese prepubertal Italian children.
abstract: OBJECTIVE
  To evaluate if insulin resistance (IR) and metabolic syndrome (MS) were associated with poor cardiovascular fitness in very obese prepubertal Italian subjects.
  
  
  METHODS
  Children referred to the Endocrinology and Diabetes Unit of Bambino Gesù Children's Hospital underwent an OGTT with glucose and insulin assays. QUICKI, ISI and HOMA-IR were calculated. Total and HDL cholesterol, triglycerides and percentage of body fat (DEXA) were determined. Cardiovascular fitness (maximal treadmill time) was evaluated using a treadmill protocol. The MS was defined as having 3 or more of following risk factors: obesity, impaired glucose tolerance, high blood pressure, low HDL-cholesterol, high triglycerides.
  
  
  RESULTS
  Fifty-five very obese prepubertal Italian children were enrolled in the study. Unadjusted correlation revealed maximal treadmill time negatively related to fasting insulin (r = -0.53, p < 0.0001) and HOMA-IR (r = -0.57, p < 0.0001) and positively to QUICKI (r = 0.51, p < 0.0001) and ISI (r = 0.46, p = 0.0035). These relationships remained significant when in multivariate analysis age, gender, BMI SD and body composition were accounted for (all p < 0.01). The presence of the MS was independently associated with maximal treadmill time.
  
  
  CONCLUSIONS
  Poorcardiovascular fitness, IR and MS were independently related, suggesting that the relationship between fitness and insulin action develops early in life.
authors.affiliation: Endocrinology and Diabetes Unit, Department of Paediatric Medicine, Bambino Gesù Children's Hospital-IRCCS, Rome, Italy. cbrufani@libero.it
authors.forename: Claudia
authors.initials: C
authors.lastname: Brufani
authors.forename: Armando
authors.initials: A
authors.lastname: Grossi
authors.forename: Danilo
authors.initials: D
authors.lastname: Fintini
authors.forename: Rossana
authors.initials: R
authors.lastname: Fiori
authors.forename: Graziamaria
authors.initials: G
authors.lastname: Ubertini
authors.forename: Diego
authors.initials: D
authors.lastname: Colabianchi
authors.forename: Paolo
authors.initials: P
authors.lastname: Ciampalini
authors.forename: Alberto
authors.initials: A
authors.lastname: Tozzi
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Barbetti
authors.forename: Marco
authors.initials: M
authors.lastname: Cappa
mesh_terms: D000367:Age Factors; D001823:Body Composition; D002319:Cardiovascular System / Q000503:physiopathology*; D002648:Child; D008076:Cholesterol, HDL / Q000097:blood; D005080:Exercise Test; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology*; D009767:Obesity, Morbid / Q000453:epidemiology* / Q000503:physiopathology; D010809:Physical Fitness; D012737:Sex Factors; D014280:Triglycerides / Q000097:blood
chemical_list: D008076:Cholesterol, HDL; D014280:Triglycerides